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Changes in Waivered Clinicians Prescribing Buprenorphine and Prescription Volume by Patient Limit
Increasing the workforce available to treat opioid use disorder (OUD) remains a priority in light of high opioid mortality and percentages of people with OUD who do not receive treatment. The Drug Addiction Treatment Act (DATA) of 2000 created a pathway for clinicians to obtain waivers (“DATA waivers”) to simultaneously treat up to 30, 100, or 275 patients with OUD outside of an opioid treatment program, provided the clinicians met certification and training requirements. Policies in 2021 reduced waiver requirements and in 2023 removed waiver requirements, leading to expectations of increased OUD treatment. It is important to understand historical clinician prescribing patterns prior to these policy changes to track the specific effects going forward. Prior research mainly relies on DATA-waiver status or prescription data alone to estimate the workforce, leading to likely overestimates. To address these limitations, this study examined trends in DATA-waivered clinicians’ active participation in prescribing buprenorphine, overall and by patient limits, between January 2017 and May 2021.
Citation: Luo Q, Erikson CE. Changes in Waivered Clinicians Prescribing Buprenorphine and Prescription Volume by Patient Limit. JAMA. 2023;329(20):1792–1794.
Documenting a Decade of Exponential Growth in Employer Demand for Peer Support Providers
The past decade has seen peer support providers increasingly incorporated as part of a recovery-oriented approach to behavioral health (BH) services for mental illness and substance use disorder. Despite this, there are few data sources to track this sector of the BH workforce, and understanding of peer support provider supply, demand, distribution, and associated factors is limited. In this retrospective, observational study, the authors analyzed job postings from 2010 to 2020 to assess employer demand for peer support providers and the factors associated with its growth, using a labor market data set from Emsi Burning Glass. The authors identified peer support job postings using a three-pronged, stepwise approach. Then, bivariate regression analyses using robust standard errors were conducted to examine state-level relationships between the number of peer support job postings per 100,000 population and Medicaid policies and indicators of states’ BH infrastructure. The authors identified approximately 35,000 unique postings, finding the number increased 17-fold between 2010 and 2020. Bivariate analysis found significant state-level associations between peer support job postings and Medicaid expansion, as well as states’ mean number of mental health facilities. This analysis represents the first to quantify employer demand for peer support providers, clearly demonstrating robust growth over time. Findings underscore the importance of continuing to develop data on this workforce to better understand factors driving its growth.
Citation: Ziemann MP, Dent RB, Schenk ED, et al. Documenting a Decade of Exponential Growth in Employer Demand for Peer Support Providers. J Behav Health Serv Res. 2023;50: 413–424.
New Behavioral Health Workforce Database Paints A Stark Picture
Using novel data sources, the Mullan Institute now has a Behavioral Health Workforce Tracker. Learn about how we identified 1.2 million behavioral health providers and how you can use our Behavioral Health Workforce Tracker to study the workforce.
Citation: Erikson C, Schenk E, Westergaard S, Salsberg ES. "New Behavioral Health Workforce Database Paints A Stark Picture". Health Affairs Forefront. August 30, 2023.
Historic Redlining and Contemporary Behavioral Health Workforce Disparities
As the nation continues to confront the lasting legacy of Jim Crow–era structural racism, attention is increasingly turning to the association between historical redlining policies and contemporary racial disparities in access to health care, including behavioral health. This exploratory cross-sectional study used 2 counties designated as mental health professional shortage areas to investigate whether behavioral health specialists are equitably allocated across redlined neighborhoods in Richmond City County, Virginia (Richmond), and Guilford County, North Carolina (Greensboro). We compare clinician-to-population ratios and other neighborhood characteristics by HOLC grade to assess the association between redlining and current clinician supply, racial and ethnic demographics, and the area deprivation index measuring income, education, employment, and housing quality.
Citation: Erikson CE, Dent RB, Park YH, Luo Q. Historic Redlining and Contemporary Behavioral Health Workforce Disparities. JAMA Netw Open. 2022;5(4):e229494.
Studies in Progress
Policies Affecting MH/SUD Provider Supply and Service to Underserved Communities
The Behavioral Health Workforce Tracker was created in partnership with HealthLandscape and was funded under grant number FG000028 from the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS). The views, policies, and opinions expressed do not necessarily reflect those of SAMHSA or HHS and should not be construed as such.